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Gangadhar Immanni, DDS
NPI 1912285032 · on the registry since 2011
Practice
- Address
- 1515 West Fir
Portales, NM 88130 - Phone
- (575) 356-6695
- Fax
- (575) 356-5948
- Organisation at this address
- La Casa De Buena Salud Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- NM
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-11-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico